Frances Reynolds

‘A lifestyle coat-hanger’: a phenomenological study of the meanings of artwork for women coping with chronic illness and disability

Purpose: The purpose of this phenomenological enquiry was to explore the meanings and functions of art for a group of women living with disabling chronic illness. Participants were recruited on the basis that they considered artwork as central to their current well-being. Method: Thirty women were interviewed and five submitted written narratives. Interpretative phenomenological analysis was carried out. Results: About half of the participants had taken up their preferred artistic occupation since the onset of illness. Participants described their artwork as contributing to their health and well-being in many diverse ways. Art filled occupational voids, distracted thoughts away from illness, promoted the experience of flow and spontaneity, enabled the expression of grief, maintained a positive identity, and extended social networks. Its value was conceptualised by one participant as a ‘lifestyle coat-hanger’ organising numerous further roles and activities that gave purpose to life. Art was more than cathartic. It offered a versatile means of overcoming the restrictions imposed by illness on self and lifestyle, in many cases creating a more enriched lifestyle than before. Conclusion: The findings may encourage professionals working in health and rehabilitation settings to assist clients in identifying meaningful, creative occupations that are feasible within the limits imposed by illness or injury.

“Sticking Jewels in Your Life”: Exploring Women's Strategies for Negotiating an Acceptable Quality of Life with Multiple Sclerosis

The authors explored womens strategies for achieving quality of life with multiple sclerosis (MS) through interviews with 27 women, most of whom had lived with MS for more than 5 years. Analysis of the semistructured interviews followed the interpretative phenomenological approach. The women portrayed living with MS as an ongoing process of negotiation and described gaining quality of life through looking after health; maintaining meaningful occupations and roles; establishing mutual relationships; clarifying beliefs, aspirations, and philosophy of life; activism on disability issues; consciously valuing positive life experiences; and finding benefits in adversity. Despite recounting resourceful strategies, many acknowledged ongoing difficulties. Some narratives suggested a mesh or tapes-try of coexisting positive and negative experiences. Others portrayed an adversarial relationship, with the positive and negative forces in their lives constantly battling for supremacy. A wide array of flexible, evolving strategies was required to achieve an acceptable quality of life with MS.

Studying psychology at degree level: Would problem-based learning enhance students' experiences?

ABSTRACT Problem-based learning is increasingly used in medical and paramedical education, both in physical and psychological science course components. Several studies confirm its value in helping students specifically to learn about applied issues such as the psychological aspects of illness and treatment. However, its relevance to the academic study of psychology at degree level has been largely unexplored. This article outlines some possible disadvantages of traditional approaches to undergraduate psychology teaching. The rationale of problem-based learning is described. Examples are given of how psychology is studied by occupational therapy students in a problem-based learning curriculum at Brunel University College, and suggestions are made for extrapolating such approaches to undergraduate psychology. Taking one ‘problem˚s as an example, comparison is made between the topics explored by different student groups, revealing the rich potential of the approach. Some evaluation is offered of the strengt...

Managing depression through needlecraft creative activities: A qualitative study

This qualitative study explored the personal meanings of needlecrafts and their role in the self-management of depression. Written and spoken narratives from 39 women were studied. Respondents described themselves as experiencing chronic or episodic depression (e.g. associated with stressful work situations, bereavement or caring for an ill relative). Some had received treatment for depression but most had not. When analysing the therapeutic effects of creative activity, most women described the experience of intense concentration in the task as providing distraction from worry and relief from depressive thoughts. Creative activity was often described as enhancing self-esteem. The adaptability of the occupation to suit time available, mood and other factors facilitated a sense of empowerment or control. Creative arts activities could also challenge depression from enabling social contacts. Most respondents had taken up their favoured creative activity in adulthood, commonly in response to stressful life events and with some self-awareness of its therapeutic potential. The diversity of subjective benefits support further research into the self-management of depression through creative activities, in both patient and non-patient groups. Managing

Coping with Chronic Illness and Disability through Creative Needlecraft

Chronic illness and impairment commonly restrict the individuals access to work and leisure activities. Furthermore, if increasingly dependent upon family care, the individual may experience loss of valued roles and self-esteem. The present study enquired into the role of a creative leisure pursuit in long-term coping with illness and disability. The qualitative study examined the written narratives of 35 women, aged 18 to 87 years. All had acquired a disability or a chronic illness in adulthood and shared needlecraft as a common leisure pursuit. In these accounts, the women described the circumstances in which needlecraft had been adopted as a leisure pursuit and the personal benefits experienced. The accounts showed that most of the women had taken up this activity in adulthood to cope with the crisis of illness. Needlecraft activities were commonly viewed as providing a means of managing pain and unstructured time, as well as facilitating self-esteem and reciprocal social roles. The womens accounts suggest that creative activity may be helpful for patients learning to cope with chronic conditions.

Health and safety of the older worker

BACKGROUND In the UK, increasing numbers of paid employees are over 60 years with further increases expected as the state pension age rises. Some concern surrounds possible increased work-related illness and accidents for people working beyond the age of 60. AIMS To identify the available evidence for health and safety risks of workers over age 60 years with respect to factors associated with injuries and accidents. METHODS Databases searched included PUBMED, OSHUpdate, National Institute for Occupational Safety and Health (NIOSHTIC-2), SafetyLit, the UK The Health and Safety Executive (HSELINE) and the Canadian Centre for Occupational Health and Safety until December 2009. Inclusion criteria were workers aged over 60 years. Findings were grouped into occupational accidents and injuries and individual and workplace factors that may have influenced risk of injury to the over-60s. RESULTS Very little direct evidence was found concerning safety practices and health risks of workers over age 60. Some safety risks were associated with specific physical declines such as age-related hearing loss. Overall, these workers had fewer accidents and injuries but these were more likely to be serious or fatal when they occurred. There was no strong evidence that work patterns, including shift work or overtime, affected safety. Protective, compensatory strategies or experience may maintain safe working practices. CONCLUSIONS Implications for health and safety risks cannot be assessed without longitudinal research on workforces with substantial numbers of workers over age 60 in order to address the healthy worker effect.

Women's experiences of increasing subjective well-being in CFS/ME through leisure-based arts and crafts activities: A qualitative study

Purpose. To understand the meanings of art-making among a group of women living with the occupational constraints and stigma of CFS/ME. The study explored their initial motives for art-making, and then examined how art-making had subsequently influenced their subjective well-being. Method. Ten women with CFS/ME were interviewed; three provided lengthy written accounts to the interview questions. Findings. Illness had resulted in devastating occupational and role loss. Participants took many years to make positive lifestyle changes. Art-making was typically discovered once participants had accepted the long-term nature of CFS/ME, accommodated to illness, and reprioritized occupations. Several factors then attracted participants specifically to art-making. It was perceived as manageable within the constraints of ill-health. Participants also tended to be familiar with craft skills; had family members interested in arts and crafts, and some desired a means to express grief and loss. Once established as a leisure activity, art-making increased subjective well-being mainly through providing increased satisfaction in daily life, positive self-image, hope, and contact with the outside world. Participants recommended provision of occupational/recreational counselling earlier in the illness trajectory. Conclusions. Creative art-making occurred as part of a broader acceptance and adjustment process to CFS/ME, and allowed some psychological escape from a circumscribed lifeworld.

Turning to art as a positive way of living with cancer: A qualitative study of personal motives and contextual influences

Why do some women turn to creative art-making after a diagnosis of cancer? Eleven women provided qualitative accounts that were analysed following guidelines for interpretative phenomenological analysis (IPA). Some described taking up artistic leisure activities initially in order to manage emotional distress. Others emphasized their need for positive well-being, taking up art to experience achievement and satisfaction, to regain a positive identity, and to normalize family dynamics in the context of living with cancer. Participants’ turn to art-making was facilitated by biographical and contextual factors, including pre-existing craft skills, long-standing personal values and coping philosophies, family role models for managing adversity, and the supportive encouragement of family and friends. Other research has acknowledged that positive lifestyle change and posttraumatic growth can occur after a cancer diagnosis, and this study reveals a multi-faceted process. The findings suggest a need for further research into the experiences that facilitate positive lifestyle change and subjective well-being among people who are living with cancer.

Exploring self-image during hot flushes using a semantic differential scale: associations between poor self-image, depression, flush frequency and flush distress

OBJECTIVES This study developed a semantic differential scale for assessing self-image during hot flushes, based on a previously published scale (Nursing Res. 35 (1986) 81). The objectives were to explore the sensitivity and validity of this scale, and to examine whether poor self-image during hot flushes is linked to flush distress, perceived control, flush frequency, flush chronicity, self-esteem and depression. METHOD Two community samples of women with current experience of hot flushes completed a postal questionnaire. RESULTS The semantic differential scale was sensitive to individual differences in self-image, and was validated through its association with measured self-esteem using a standardised scale. Defining the self in negative ways during flushes was highly predictive of flush distress. Poor self-image was also closely associated with depression. Correlations with perceived control, and flush frequency were weaker and did not reach significance in the second, smaller sample. CONCLUSION The study extends previous findings that women low in self-esteem have more difficulty coping with menopausal changes, by showing that negative self-appraisal during flushes (e.g. defining self as unattractive or dirty) are highly demoralising and associated with distress. The findings suggest that cognitive behavioural strategies of challenging and re-interpreting thoughts about self could be helpful in moderating the discomfort and stressfulness of hot flushes for women not taking HRT. However, the findings are based on relatively small, volunteer samples and require further replication.

Psychological responses to menopausal hot flushes: Implications of a qualitative study for counselling interventions

Abstract There is relatively little research concerning womens experiences of menopausal problems. This questionnaire study explored womens descriptions of their thoughts and concerns during menopausal hot flushes, identifying cognitive and emotional factors that are particularly related to high levels of self-reported distress. Women more highly distressed by hot flushes tend to report more numerous flush episodes but also face more catastrophizing thoughts and negative self-definitions. Lack of information and effective medical support is a common problem. On the basis of this study, together with a review of the limited psychological interventions that have been published in this area, several facets of flush distress are identified that may be addressed in counselling. Women unwilling or unable to take hormone replacement therapy (HRT) may find it helpful to become aware of the role of negative thoughts and fears in magnifying flush distress. Some may need to grieve for a changed body-image. Active ...